scleral buckle

This is a surgical procedure used to repair a retinal detachment.  With this procedure, a silicone band is inserted around the eye and cinched tight, like a belt around a waistline. This decreases traction forces inside the eye which allows the retina to lay back in its normal position. Scleral buckle surgery is widely performed and used to be the only viable treatment for retinal detachments. Other techniques have arisen such as vitrectomy and pneumatic retinopexy.  Every retina specialist has their own surgical preferences and the technique chosen depends upon circumstances and the location of retinal breaks. Some retina surgeons seem to be leaning toward vitrectomy as improvements in retina instrumentation have made vitrectomies fast and less traumatic. There are benefits and risks in all these retinal procedures.  One potential problem with a scleral buckle is that the silicone band tends to make the eye physically longer and this can change the overall refractive error of the eye. It’s fairly common for the eye to become extremely nearsighted. This can be fixed with a change in glasses prescription, but if the difference between the eyes becomes too great, the glasses won’t be comfortable to wear and a contact lens might be required instead.  Fortunately, most of these balance issues can be fixed during cataract surgery or with LASIK if they become too bothersome.  Less easy to fix is the potential for strabismus, where the buckle makes the eyes slightly out of alignment, causing double vision.  Retinal detachments are serious, so these risks are acceptable given the alternative (a blind eye).

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Dr. Timothy Root is a practicing ophthalmologist and cataract surgeon in Daytona Beach, Florida. His books, video lectures, and training resources can be found at:

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